Five and a half years extra life expectancy after 30 years. Not bad. An extra 30 after 100 years. Nice. I guess the combination of stress, pollution, moral decrepitude, corroded job protections, declining medical care and all the other crises of the day are actually coincident with increased lifespan. Don't be optimistic about it; it's not fashionable.

Posted by Sam Dinkin at December 28, 2007 12:58 PM

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Duncan, keep in mind also that many stillborns are now considered infant deaths. That has resulted in less of an improvement in infant mortality than one would expect. And it's well known that people at all ages are living longer than before.

I've also heard more people suffer from obesity and it's related problems than malnutrition now. I know definitions may vary, but it is still quite a feat to get close considering how many mouths need feeding nowadays.

If you live an extra year near middle age, you didn't die on purpose, on accident or of an infection. So you get a little extra life expectancy from better medical care expected and from living an extra year and avoiding becoming a death statistic. Morbidity increases as one gets older until it peaks around 10-13%. That is, once you get old enough (80 or so), every extra year of life gives you almost a full extra year of life expectancy. That suggests that systems degrade down to a net 8-10 year mean-time-to-fatal failure, then don't degrade further with age systematically without suffering fatal failure. So there are two ways to increase lifespan: delay onset of degradation of systems and increase reliability at the old-age plateau.

My intuition is that a lot of deaths are related to poor continuity of basic care: food, water, exercise, and sleep. If memory starts to go, meals can get missed. If pain ensues, sleep can get interrupted. This is especially true if a caregiver dies or gets very ill. If one is in hospice and is taking morphine, it's very easy to get dehydrated or malnourished. If mobility is compromised in a fall, again, crisis.

So it's possible the proximate cause of death can be delayed by reducing accidents, improving nutrition, improving elder care, improving elder mental health, improving family services, and improving elder safety especially when immobilized or when there is no supervision by third or first parties. That is, a broken hip may lead to a cardiac case, an infection or a suicide. (Is a DNR partially a suicide?)

I still think, though, that the biggest increase in concious life would be to research healthy living on less sleep. 4 hours fewer asleep a night could increase awake-time expectancy at birth by 13 years.

"My intuition is that a lot of deaths are related to poor continuity of basic care: food, water, exercise, and sleep.
Posted by Sam Dinkin at December 29, 2007 02:14 PM"

I agree, many geriatrics forgot to drink water in fact and tend to become dehydrated over long periods of time. Ever see an old person with thin delicate skin that becomes so dry that it cracks and bleeds if you knock it to hard. These provide for constant infection sites since the poor circulation due to dehydration weakens healing.

I used to think there were three basic killers for otherwise healthy people in our society; Smoking, excessive drinking, and excessive eating. Since my recent education, I have added lack of proper sleep due to the way it kills us slowly through indirect damage.

Good luck with the 4 hours a night thing. I won't be on the list of volunteers for the experiments. 8)